EP1715814A1 - Medizinprodukt mit glatter gehärteter oberfläche - Google Patents

Medizinprodukt mit glatter gehärteter oberfläche

Info

Publication number
EP1715814A1
EP1715814A1 EP05701974A EP05701974A EP1715814A1 EP 1715814 A1 EP1715814 A1 EP 1715814A1 EP 05701974 A EP05701974 A EP 05701974A EP 05701974 A EP05701974 A EP 05701974A EP 1715814 A1 EP1715814 A1 EP 1715814A1
Authority
EP
European Patent Office
Prior art keywords
medical device
depth
surface layer
chromium
cobalt
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP05701974A
Other languages
English (en)
French (fr)
Inventor
David V. Dunsmore
Hubert Patrovsky
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
PATT TECHNOLOGIES Inc
Orchid Orthopedic Solutions Sheffield Ltd
Original Assignee
PATT TECHNOLOGIES Inc
Doncasters PLC
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by PATT TECHNOLOGIES Inc, Doncasters PLC filed Critical PATT TECHNOLOGIES Inc
Publication of EP1715814A1 publication Critical patent/EP1715814A1/de
Withdrawn legal-status Critical Current

Links

Classifications

    • C—CHEMISTRY; METALLURGY
    • C23—COATING METALLIC MATERIAL; COATING MATERIAL WITH METALLIC MATERIAL; CHEMICAL SURFACE TREATMENT; DIFFUSION TREATMENT OF METALLIC MATERIAL; COATING BY VACUUM EVAPORATION, BY SPUTTERING, BY ION IMPLANTATION OR BY CHEMICAL VAPOUR DEPOSITION, IN GENERAL; INHIBITING CORROSION OF METALLIC MATERIAL OR INCRUSTATION IN GENERAL
    • C23C—COATING METALLIC MATERIAL; COATING MATERIAL WITH METALLIC MATERIAL; SURFACE TREATMENT OF METALLIC MATERIAL BY DIFFUSION INTO THE SURFACE, BY CHEMICAL CONVERSION OR SUBSTITUTION; COATING BY VACUUM EVAPORATION, BY SPUTTERING, BY ION IMPLANTATION OR BY CHEMICAL VAPOUR DEPOSITION, IN GENERAL
    • C23C8/00—Solid state diffusion of only non-metal elements into metallic material surfaces; Chemical surface treatment of metallic material by reaction of the surface with a reactive gas, leaving reaction products of surface material in the coating, e.g. conversion coatings, passivation of metals
    • C23C8/06—Solid state diffusion of only non-metal elements into metallic material surfaces; Chemical surface treatment of metallic material by reaction of the surface with a reactive gas, leaving reaction products of surface material in the coating, e.g. conversion coatings, passivation of metals using gases
    • C23C8/08—Solid state diffusion of only non-metal elements into metallic material surfaces; Chemical surface treatment of metallic material by reaction of the surface with a reactive gas, leaving reaction products of surface material in the coating, e.g. conversion coatings, passivation of metals using gases only one element being applied
    • C23C8/24—Nitriding
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/02—Inorganic materials
    • A61L27/04—Metals or alloys
    • A61L27/045—Cobalt or cobalt alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/02—Inorganic materials
    • A61L27/04—Metals or alloys
    • A61L27/047—Other specific metals or alloys not covered by A61L27/042 - A61L27/045 or A61L27/06
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/28—Materials for coating prostheses
    • A61L27/30—Inorganic materials
    • A61L27/306—Other specific inorganic materials not covered by A61L27/303 - A61L27/32
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/3094—Designing or manufacturing processes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/38—Joints for elbows or knees
    • A61F2/3859—Femoral components
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A61F2/389—Tibial components
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30682—Means for preventing migration of particles released by the joint, e.g. wear debris or cement particles
    • A61F2002/30685—Means for reducing or preventing the generation of wear particulates
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30836—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves knurled
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/3085—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30891—Plurality of protrusions
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2002/30929—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth having at least two superposed coatings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2002/30934—Special articulating surfaces
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3611—Heads or epiphyseal parts of femur
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3625—Necks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/365—Connections of heads to necks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4631—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor the prosthesis being specially adapted for being cemented
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00029—Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00035—Other metals or alloys
    • A61F2310/00059—Chromium or Cr-based alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00856—Coating or prosthesis-covering structure made of compounds based on metal nitrides
    • A61F2310/00886—Coating made of chromium nitride

Definitions

  • the present invention relates generally to medical devices and, more particularly, to a medical device comprising a cobalt-chromium alloy and having a hardened, wear resistant surface of minimal abrasiveness.
  • a material must exhibit the appropriate functional properties, mainly mechanical properties, for the particular application and must be biocompatible. Biocompatibility is the ability of a material to perform with an appropriate host response in a particular application.
  • metal alloys are subject to electrochemical corrosion with the bodily fluids acting as an electrolyte and, to be biocompatible, a metal alloy used in an implantable medical device must exhibit very low corrosion over the projected lifetime of the device. Metal particles released by corrosion may be concentrated locally or distributed systemically and it is important that the type and amount of material released does not pose a danger to the patient.
  • Cobalt-chromium based alloys developed for the aerospace industry, are used in many medical device applications, including implantable medical devices, because of their strength, corrosion resistance, and biocompatibility.
  • cobalt-chromium alloys typified by alloys conforming to ASTM standard specifications, such as, ASTM F-75-01 , STANDARD SPECIFICATION FOR COBALT-28 CHROMIUM-6 MOLYBDENUM ALLOY CASTINGS AND CASTING ALLOY FOR SURGICAL IMPLANTS, and ASTM-799, STANDARD SPECIFICATION FOR COBALT-28 CHROMIUM-6 MOLYBDENUM ALLOY FORGINGS FOR SURGICAL IMPLANTS, are often used as components of modular prosthetic devices such as prosthetic hip and knee joints.
  • a prosthetic joint typically includes paired load bearing surfaces, commonly comprising a first surface of a metal alloy component paired with a second surface comprising a metal, a polymer, a ceramic, bone, or bone cement.
  • load bearing surfaces move relative to each other, such as during articulation of a prosthetic joint, friction can cause the surfaces to spall.
  • the wear debris known medically as third bodies, originating from the load bearing surfaces of an implanted medical device can initiate a histiocytic reaction in which the body's immune system is activated to release enzymes to dissolve the particles of debris.
  • the wear debris is usually a relatively hard material, such as a metal or polycarbon compound
  • the enzymes either fail to dissolve the debris or dissolve the debris only with the passage of considerable time.
  • the enzymes do react with tissue and bone and may weaken or dissolve the bone supporting or adjacent to the medical device.
  • weakening of the bone or osteolysis may shorten the life of the device and may eventually render the supporting bone unusable.
  • surface erosion can eventually lead to failure of the load-bearing surfaces, requiring replacement or repair of the surfaces.
  • replacement or repair entails expensive and risky surgery.
  • the surface of a cobalt-chromium alloy may be hardened by depositing a titanium nitride coating on the surface, or by ion implantation of the cobalt-chromium matrix.
  • Surface hardening methods also include gas nitriding, chemical salt bath nitriding, plasma or ion nitriding, and ion implantation.
  • Cobalt-chromium based alloys can also be strengthened by adding nitrogen to the alloy in the molten state or by diffusing nitrogen into the alloy in the solid state. Specifically, forming gas comprising 15% hydrogen and 85% nitrogen, in combination with either ammonia or argon, may be used to diffuse nitrogen into a cobalt-chromium alloy.
  • the result is a hardened diffusion layer bounded by the surface and a substrate of cobalt-chromium alloy.
  • This process enhances the hardness and wear resistance of the surface of the cobalt-chromium alloy with minimal reduction in fatigue resistance.
  • exposing the surface to pure nitrogen at 1-2 psig. positive pressure and at a temperature in the specified range prevents the formation of a chromium nitride compound layer on the surface which would increase surface roughness and reduce wear resistance.
  • the paired load bearing surface is commonly a dissimilar material, such as a polymer, a ceramic, bone, or bone cement which is also subject to wear.
  • a substantial majority of total hip and knee replacements have incorporated either a conventional or highly cross-linked ultra-high-molecular-weight-polyethylene (UHMWPE or UHMWXLPE) for the second of the paired load bearing surfaces because of the low coefficient of friction between polyethylene and cobalt-chromium surfaces.
  • UHMWPE ultra-high-molecular-weight-polyethylene
  • UHMWXLPE ultra-high-molecular-weight-polyethylene
  • FIG. 1 is a schematic diagram depicting a prosthetic hip joint in place.
  • FIG. 2 is a micrograph of a sample of a casting comprising a cobalt-chromium alloy.
  • FIG. 3 is a flow diagram of a surface treatment process to create a hardened, wear resistant, minimally abrasive surface on a component comprising a cobalt-chromium alloy.
  • FIG. 4 is a schematic diagram depicting a prosthetic knee joint in place.
  • FIG. 5 is a schematic diagram depicting the parts of an exemplary prosthetic knee joint. [00015] FIG.
  • FIG. 6 is a micrograph of a sample of a cobalt-chromium alloy having a surface layer substantially comprising chromium nitride.
  • FIG. 7 is a micrograph of a second sample of a cobalt-chromium alloy having a surface layer substantially comprising chromium nitride.
  • an artificial joint such as the prosthetic hip joint 20
  • a medical device exemplifies a medical device, and, more specifically, an implantable medical device, that includes a pair of interfacing load bearing surfaces arranged to move relative to each other.
  • the prosthetic hip joint 20 typically includes a ball 22 that is connected to a body 24 comprising a neck 26 and a stem 28.
  • the stem 28 may be held in place in the femur 30 by a variety of methods, including the use of cementing agents 29, an interference fit, a threaded attachment mechanism, or biological fixation.
  • a cup-shaped socket 32 is anchored in the pelvis 34 by any of a variety of known techniques, such as cementing; press fitting; the use of screws; the use of a textured, knurled, or threaded exterior; the use of a biological fixation mechanism or by a combination of biological and mechanical fixation.
  • the ball 22 is positioned adjacent to the concave surface of the socket 32.
  • a socket insert 36 commonly comprising a polymer, such as an ultra-high molecular weight polyethylene (UHMWPE) or an ultra-high molecular weight, cross linked polyethylene (UHMWXLPE), is disposed within the socket 32 to reduce friction between the ball 22 and the socket and increase the life of the joint.
  • UHMWPE ultra-high molecular weight polyethylene
  • UHMWXLPE ultra-high molecular weight, cross linked polyethylene
  • the socket insert 36 may comprise ceramic or metal or a ceramic or metal socket may be used without a socket insert.
  • the second load bearing surface in contact with a surface of a medical device component of cobalt- chromium comprises bone or bone cement.
  • the convex outer surface of the ball 22 interfaces with the concave load bearing surface of the socket insert 36 or socket 32, as appropriate, to allow the joint to rotate and articulate simulating the movement of the natural hip joint.
  • the ball 22 comprises a cobalt-chromium alloy. Additional components of the prosthetic hip joint 20, including the body 24 and the socket 32 may also comprise a cobalt chromium alloy.
  • Cobalt- chromium alloys are alloys comprising significant portions of cobalt and chromium and, commonly, also include a significant portion of molybdenum.
  • Cobalt-chromium alloys used in medical devices are typified by alloys complying with ASTM standard specifications, ASTM F-75-01 , STANDARD SPECIFICATION FOR COBALT-28 CHROMIUM-6 MOLYBDENUM ALLOY CASTINGS AND CASTING ALLOY FOR SURGICAL IMPLANTS, and ASTM-799, STANDARD SPECIFICATION FOR COBALT- 28 CHROMIUM-6 MOLYBDENUM ALLOY FORGINGS FOR SURGICAL IMPLANTS.
  • Cobalt-chromium alloys also include alloys that have higher minor portions of carbon or nitrogen and comply with an ASTM F-75 Modified specification.
  • cobalt-chromium alloys include other proprietary alloys that contain cobalt and chromium and resemble alloys conforming to the ASTM-F75, modified ASTM-F75, and ASTM-799 standard specifications.
  • the prosthetic knee joint includes a femoral component 82 and a tibial component 84.
  • the femoral component 82 includes a patella track 87 and condyles 86 which include a load bearing surface 88.
  • the femoral component 82 may also include pegs 90 for locating or affixing the femoral component to the femur.
  • the tibial component 84 includes a tibial base 92 with a peg 94 for locating or mounting the tibial base onto the tibia.
  • a tibial platform 96 is mounted atop the tibial base 92 and includes grooves 98 complementary in shape to the condyles 86 of the femoral component 82.
  • the load bearing surfaces 88 of the condyles 86 contact the grooves 98 of tibial platform 96.
  • the condyles 86 and patella track 87 are typically manufactured of metal, such as a cobalt-chromium alloy
  • the tibial platform 92 is typically manufactured from a polymer, such as UHMWPE, or a polymer based composite.
  • articulation of the metal load bearing surfaces of the condyles 86 and the patella track 87 against the relatively softer tibial platform 96 may result in wearing of the surfaces of the tibial platform and the production of polymeric wear debris.
  • cobalt-chromium alloys are often used in medical devices because of their strength, corrosion resistance, and biocompatibility
  • the inventors realized that it is the nature of cobalt-chromium alloys to form isolated particles of carbides of the constituent metals of the alloy. These carbide particles are of random size and are dispersed randomly through the base metal matrix. Referring to FIG. 2, some of the carbide particles 42 form at the surface 44 of the body 40 of the cobalt-chromium component.
  • the carbide particles are relatively hard compared to the cobalt-chromium base metal.
  • the base material is typically softer than the carbide particles, it is commonly harder than the paired load bearing surface and, with relative movement of the surfaces, the edges of the grains scrape material from the paired load bearing surface.
  • the inventors came to the unexpected realization that creation of a surface layer substantially comprising chromium nitride could produce a medical device with a very smooth, hardened surface of minimal abrasiveness.
  • the surface layer seals off discontinuities created by the intersections of grain boundaries with the surface and submerges carbide particles at the surface in a smooth layer of biocompatible chromium nitride that is harder than the carbide.
  • the inventors also determined that exposing a surface of a body comprising cobalt and chromium to a reaction gas, including nitrogen, at a pressure less than atmospheric and at a temperature between 250°C and 1000°C for a period of time would cause the growth of a smooth compound surface layer comprising substantially chromium nitride.
  • a reaction gas including nitrogen
  • FIG. 3 The steps of the surface treatment process 50 for creating a smooth, hardened, minimally abrasive surface for a medical device comprising a cobalt chromium alloy are illustrated in FIG. 3. Commonly, the medical devices to be treated by the process 50 are received for treatment in a fully polished and color buffed condition.
  • the components are cleaned 52 to remove any foreign material, such as finger prints, finishing or machining oils, polishing or buffing compounds, or other materials encountered during manufacturing, shipping, or handling of the components.
  • Cleaning methods include, but are not limited to, ultrasonic cleaning with and without soaps or surfactants, degreasing with commercially available degreasers, and chemical etching with acids or caustic materials.
  • the components are typically loaded into appropriate fixtures 54.
  • the fixtures optimize the exposure of the surfaces to be treated, mask surfaces that are not to be treated, and minimize the opportunity of contact between neighboring components in a batch or load in a reaction vessel.
  • the fixture also promotes equal exposure of all of the components in a load to the process environment in the reaction vessel.
  • the components are loaded into a reaction vessel suitable for plasma nitriding 56 and the reaction vessel is closed and sealed 58.
  • the environmental gases that entered the reaction vessel during loading are typically purged from the sealed vessel 58.
  • Purging typically comprises the steps of evacuating the reaction vessel to a pressure less than atmospheric and, typically, a pressure less than 1 millibar (mbar), followed by the introduction of nitrogen to force remaining environmental gases out of the reaction vessel.
  • Purging is typically conducted at a temperature between the ambient temperature and 300°C.
  • the specific temperature during purging is determined experimentally and is influenced by the construction of the components to be treated, including the sizes of the components and thicknesses of the various sections of the components, and the sizes and weights of the components making up the load in the reaction vessel. For example, when processing a fully loaded reaction vessel containing a plurality of femoral components of a prosthetic knee, such as the femoral knee component 82, a temperature of approximately 250°C has been found to be appropriate. [00028]
  • the reaction vessel is evacuated to a pressure less than one atmosphere and then back-filled to a partial vacuum with a reaction gas 62. While the constituency of the reaction gas can be varied for specific components or loads, the reaction gas is typically a mixture of nitrogen, argon, and hydrogen.
  • a mixture of 4-8% nitrogen, 2-4% argon, and 94-98% hydrogen, by volume at a pressure less than one atmosphere, has been found to be suitable for treating a full reaction vessel of femoral knee components 82.
  • trace amounts of methane may be added to the reaction gas to stabilize the carbon in the treated components.
  • the reaction gas is introduced at a pressure of 2-4 mbar when processing an exemplary load of femoral knee components 82.
  • the temperature in the reaction vessel is gradually increased and a pulsing voltage is applied to the reaction gas 64 to clean the exposed surface in preparation for the creation of a chromium nitride surface layer.
  • the temperature is raised, at a rate of approximately 150°C per hour, from approximately 200°C to 500°C over a period not less than 2 hours or more than 5 hours.
  • a voltage applied to the reaction gas produces a plasma in the reaction vessel.
  • a pulsed voltage between 450V and 500V with an on-to-off time ratio for the pulse of approximately 2:5 is applied to the reaction gas.
  • Altering the voltage pulses and the constituency and temperature of the reaction gas 66 initiates a first stage of growth of the compound surface layer.
  • a first stage reaction gas comprising 5-10% nitrogen and, correspondingly, 95-90% hydrogen is introduced to the reaction vessel.
  • the reaction gas may also contain small amounts of argon or methane.
  • a partial vacuum with a pressure less than one atmosphere and, preferably, less than 100 mbars is maintained for the reaction gas and the temperature in the reaction vessel is maintained between 450°C and 600°C for 3-6 hours.
  • the reaction gas is introduced to the reaction vessel at a flow rate of approximately 150 - 300 liters per hour with a pressure of 2-4 mbar and the temperature is maintained at 580°C for approximately four hours.
  • the reaction gas is excited with an electrical pulse of, typically, 450-550 volts with an on-to-off time ratio of approximately 1 :2.
  • the reaction gas and the pulse voltage are revised to continue the growth of the surface layer 68 and minimize the diffusion of nitrogen into the component.
  • the concentration of nitrogen in the reaction vessel is increased for the second stage of surface layer growth 68.
  • the percentage of nitrogen in the reaction gas may be increased from 5% for first stage of surface layer growth 66 to 7.5% for second stage of surface layer growth 68.
  • Trace amounts of methane are typically included in the reaction gas during this second stage of surface layer growth to stabilize the carbon in the components.
  • a pressure less than one atmosphere, and preferably less than 100 mbars, is maintained in the reaction vessel during the second stage of surface layer growth 68.
  • the pulse voltage is reduced to approximately 480 volts for processing the exemplary load of femoral knee components.
  • the components are exposed to the plasma of the second stage reaction gas for 10-20 hours during the second stage of surface layer growth 68.
  • the higher concentration of nitrogen in the reaction gas and lowered pulse voltage produces a second stage plasma that facilitates growth of the compound surface layer while minimizing or avoiding the development of a diffusion layer.
  • the temperature in the reaction vessel is reduced and the pressure is increased 70 in preparation for removing the components from the reaction vessel. Over a period of approximately 8 hours, as determined by the size of the load in the reaction vessel, the temperature in the reaction vessel is reduced to approximately 120°C and the pressure is increased to approximately atmospheric by the introduction of nitrogen gas.
  • the processed components are then removed from the reaction vessel 72 and any final finishing 74, typically limited to polishing for appearance, is performed.
  • the surface treatment process 50 causes a compound surface layer 100 to develop at the surface of a body 102 comprising a cobalt- chromium alloy matrix.
  • the surface layer 100 comprises substantially biocompatible chromium nitride.
  • the surface layer is hard and smooth and subsumes particles of carbide, such as the particle 104, at the surface of the body 102 and seals over surface discontinuities, such as those resulting from the intersection of grain boundaries 106 with surface of the body 110.
  • Analysis confirms that components of cobalt-chromium alloy subjected to the surface treatment process 50 develop a 3-15 micron thick compound surface layer substantially comprising chromium nitride that transitions to the cobalt- chromium base metal of the body by way of a transition layer that is much thinner than the surface layer.

Landscapes

  • Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Medicinal Chemistry (AREA)
  • Epidemiology (AREA)
  • Inorganic Chemistry (AREA)
  • Dermatology (AREA)
  • Engineering & Computer Science (AREA)
  • Organic Chemistry (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Materials Engineering (AREA)
  • Mechanical Engineering (AREA)
  • Metallurgy (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Materials For Medical Uses (AREA)
  • Prostheses (AREA)
EP05701974A 2004-01-23 2005-01-21 Medizinprodukt mit glatter gehärteter oberfläche Withdrawn EP1715814A1 (de)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US53855104P 2004-01-23 2004-01-23
US10/768,762 US20050164041A1 (en) 2004-01-23 2004-01-29 Medical device having a smooth, hardened surface
PCT/GB2005/000211 WO2005070344A1 (en) 2004-01-23 2005-01-21 A medical device having a smooth, hardened surface

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US20090145841A1 (en) * 2005-10-19 2009-06-11 Koichi Arai Perforated Member
GB2431893B (en) 2005-11-01 2009-12-16 Doncasters Ltd Medical prosthesis implant casting process
GB2443797A (en) * 2006-11-16 2008-05-21 Biomet Uk Ltd Prosthesis
US7833274B2 (en) * 2007-05-16 2010-11-16 Zimmer, Inc. Knee system and method of making same
US20090164012A1 (en) * 2007-12-21 2009-06-25 Howmedica Osteonics Corp. Medical implant component and method for fabricating same
CH701726B1 (it) * 2010-05-11 2011-03-15 Medacta Int Sa Substrato per giunti ortopedici resistenti all'usura, in metallo non ferroso, con rivestimento a base di nitruri.
WO2015191956A1 (en) 2014-06-13 2015-12-17 Acuitive Technologies, Inc. Joint replacement or joint resurfacing devices, systems and methods
SE543241C2 (en) 2018-04-27 2020-10-27 Episurf Ip Man Ab An implant for cartilage and / or bone repair
CN114831780A (zh) * 2022-03-25 2022-08-02 四川大学华西医院 含氮化层钴合金骨小梁股骨髁假体及制备方法

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